Psychological Trauma:

Theory, Research, Practice, and Policy

© 2020 American Psychological Association 2020, Vol. 12, No. S1, S6 –S14
ISSN: 1942-9681 http://dx.doi.org/10.1037/tra0000930

The Effect of the 2019 Novel Coronavirus Pandemic on College

Students in Wuhan

Dong Yang Chia-Ching Tu

Rangsit University Dhurakij Pundit University

Xiao Dai
Krirk University
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Objective: This study explored a multiple mediation model in Wuhan’s college students. Positive
thinking and resilience were identified as mediators between 2019 novel coronavirus (2019-nCoV)
victimization experiences and mental health. Method: The sample included 384 from 4 universities in
Wuhan, China. Four structured instruments were applied to the college students, including scale of the
2019-nCoV coronavirus victimization experience, scale of the positive thinking, scale of the resilience,
and scale of the mental health. The responses were scored using a 5-point Likert scale. Structural equation
models were used to construct measurement and structural models. Results: The findings confirmed that
the 2019-nCoV victimization experience was a negative predictor of mental health; positive thinking and
resilience were strong mediators between 2019-nCoV victimization experience and mental health.
Conclusions: The results indicated that a complete model was significant because positive thinking
compensated for resilience. Notably, these 2 strong mediators will vastly resist the negative influences
of 2019-nCoV victimization experience on mental health in Wuhan’s college students until the end of the
pandemic.

Clinical Impact Statement

The negative effect of 2019 novel coronavirus (2019-nCoV) victimization experience would not fully
affect mental health in Wuhan’s college students because positive thinking and resilience partially
hinders the relationship between the 2019-nCoV victimization experience and mental health.

Keywords: 2019-nCoV victimization experience, mental health, positive thinking, resilience, Wuhan

A disaster is a large-scale negative event that causes psycho-
logical trauma and even death (Goldmann & Galea, 2014). The
U.S. Department of Health & Human Services (USHHS, 2019)
classified outbreaks of infectious diseases as a type of disaster. The
2019 Novel Coronavirus (2019-nCoV) has been reported in more
than 200 countries or areas with a total of 1,353,361 confirmed
cases and 79,235 deaths, as of April 8, 2020 (WHO, 2020).
Editor’s Note. This article received rapid review due to the time-sensitive
nature of the content. It was reviewed by the Journal Editor.—KKT
This article was published Online First June 18, 2020.
Dong Yang, Suryadhep Teachers College, Rangsit University;
X Chia-Ching Tu, Department of Educational Management, CHINA-
ASEAN International College, Dhurakij Pundit University; Xiao Dai,
International College, Krirk University.
Correspondence concerning this article should be addressed to Chia-
Ching Tu, Department of Educational Management, CHINA-ASEAN In-
ternational College, Dhurakij Pundit University, 110/1-4 Prachachuen
Road, Laksi, Bangkok 10210, Thailand. E-mail: chia-ching.tu@dpu.ac.th
or tulisa0929@gmail.com
COVID-19 was first identified in December 2019 in Wuhan,
China (Zhu et al., 2020). As observed during the severe acute
respiratory syndrome (SARS), psychological problems and
posttraumatic stress symptoms can occur among residents. In-
fected friends or family, fear of being infected, or the experi-
ence of someone dying nearby can all lead to mental health
symptoms. Therefore, Wuhan residents require urgent attention
(Xiang et al., 2020). Traumatic events are inevitable for numer-
ous young people. These events can also enable people to learn
how to cope with future stressful life events. Individuals can
face negative emotions and life challenges more actively and,
thus, establish new ideas of life (Aldwin, 1994; Zoellner &
Maercker, 2006).
Cognitive appraisal theory describes a mediating mechanism
titled “cognition– evaluation–relationship” and indicates that the
harmfulness of a stimulus can be affected by “evaluation” (Folk-
man & Lazarus, 1984). Because victimization experiences were
identified as harmful stimuli, a negative relationship is formed
between negative life experiences and mental health. However,
when the stimulus is evaluated as a low-hazard stimulus to mental
health it may reduce the negative impact. Accordingly, we pro-
posed a suitable mediator called positive thinking (Norem &

S6
 EFFECTS OF 2019-NCOV ON COLLEGE STUDENTS IN WUHAN
Chang, 2002), which may protect against the negative effect of
2019-nCoV on mental health.
Researchers have also identified resilience as a protective factor
to cope with psychological trauma (Goldmann & Galea, 2014),
which can also protect against the development of posttraumatic
stress disorder (PTSD) after disasters (Thompson, Fiorillo, Roth-
baum, Ressler, & Michopoulos, 2018). It is a common mediating
variable in studies (Bajaj & Pande, 2016; Karreman & Vinger-
hoets, 2012). Therefore, resilience was proposed as the second
mediator. However, resilience has its limits. In the model of
resilience development, the protective function of resilience was a
positive adaptation to stressors. The protective effects on mental
health depended on the extent of risk factors and whether their
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duration exceeded individual endurance (Masten & Reed, 2002).
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Therefore, this study explored the effect of 2019-nCoV victim-
ization experience on mental health in Wuhan college students and
investigated the mediating roles of positive thinking and resilience
in the relationship between 2019-nCoV victimization experience
and mental health.
2019-nCoV Victimization and Mental Health
Studies have reported that adults with disaster victimization
experiences may develop sleep disorders, depression, emotional
distress, and worsening psychological symptoms (Becker-Blease,
Turner, & Finkelhor, 2010; Bonanno et al., 2008; Steel, Silove,
Phan, & Bauman, 2002). The psychological trauma is reportedly
related to thinking and cognitive regulation, and cognition styles
characterized by negative thinking traits may result in PTSD after
disaster events (Su & Chen, 2008). Students with trauma exposure
and negative cognitions during negative life events reported the
worst mental health (Artime, Buchholz, & Jakupcak, 2019). More-
over, research on disaster exposure showed that PTSD and depres-
sion trauma did not entrain positive growth concerning mental
health (Schneider et al., 2019). In fact, the negative effects of the
victimization experience on mental health were reported consis-
tently. Thus, this study’s first primary hypothesis was as follows:
Hypothesis 1: 2019-nCoV victimization experience exerts a
significant negative effect on mental health among college
students in Wuhan.
2019-nCoV Victimization Experience, Positive
Thinking, and Mental Health
Although few studies have reported the relationship between
disaster experience and positive thinking, individuals exposed to
disasters often reported negative coping strategies, which were
related to poor positive-thinking performance (Cadamuro, Versari,
Vezzali, Giovannini, & Trifiletti, 2015). Victimization from disas-
ters or major life events can impair healthy function as the degree
of disaster increases by causing a continuously negative cognitive
emotion experience (Arnason, 2009; Wu, He, & Li, 2009). Ac-
cording to previous studies, a negative attributional style or pre-
vious trauma history may hinder positive thinking when faced with
a disaster (Cadamuro et al., 2015; Wu et al., 2009). Positive
thinking has been demonstrated to be a positive predictor of mental
health (Aspinwall & Tedeschi, 2010; Bekhet, 2013; Naseem &
Khalid, 2010; Tugade & Fredrickson, 2004); enough that events
that hinder it impact both mental and physical health.
S7
Cognitive appraisal is an assessment for evaluating a stimulus
(Jermann et al., 2006). This mechanism plays a mediating role
between “cognition” and “relationship” (Folkman & Lazarus,
1984). In this study, positive thinking was defined as an optimistic
manner of thinking and, thus, a potential mediator in the present
study. Hypothesis 2 as follows:
Hypothesis 2: Positive thinking mediates the relationship be-
tween 2019-nCoV victimization experience and mental health
in Wuhan college students.
2019-nCoV Victimization Experience, Resilience, and
Mental Health
Resilience is a powerful protective factor when facing negative
life events (Peng et al., 2012). However, a study revealed that
children with high resilience reported more anxiety and depres-
sion; thus, resilience may develop as a result of the influence of
negative experiences (Yu & Zhang, 2005). Researchers have found
that multiple negative major life stressors could not reduce resil-
ience (Morin, Galatzer-Levy, Maccallum, & Bonanno, 2017).
However, resilience was not sufficient for coping with high levels
of disaster victimization experiences and may be impaired if
disasters carry high risks (Arnason, 2009). Children and adoles-
cents with low resilience were identified as being at a higher risk
of mental health problems (Hildebrand, Celeri, Morcillo, & Za-
nolli, 2019).
Resilience is defined as an ability to “bounce back” and protects
mental health. Individuals with high resilience return to a healthy
psychological state rapidly during a disaster (Goldmann & Galea,
2014). In one study, the resilience of individuals and the commu-
nity protected the majority of forced migrants against poor mental
health outcomes (Jakovljevic, 2018; Siriwardhana, Ali, Roberts, &
Stewart, 2014). Thus, individual resilience interventions could
improve mental health outcomes in children, adolescents, and
college freshmen (Chow & Choi, 2019; Dray et al., 2017, 2015).
However, the infectious disease epidemic investigated in this study
may result in different degrees of psychological trauma and neg-
ative emotions (Park, Lee, Park, & Choi, 2018). Resilience may
still have a positive effect on the victimization process if the
degree of the disaster is at an acceptable level. Resilience may
become a defense against negative influences of 2019-nCoV on
mental health (Arnason, 2009; Masten & Reed, 2002; Morin,
Galatzer-Levy, Maccallum, & Bonanno, 2017). Therefore, a me-
diating Hypothesis 3 was derived as follows:
Hypothesis 3: Resilience has a mediating effect on the rela-
tionship between 2019-nCoV victimization experience and
mental health in Wuhan’s college students.
Hypothetical Model
The hypothetical model was constructed based on studies and
theories. A 2019-nCoV victimization experience was assumed to
be a negative factor in mental health, and positive thinking and
resilience were proposed as two mediators. Figure 1 illustrates the
hypothetical model as follows:
 S8 YANG, TU, AND DAI

questionnaire was used to collect samples from four universities in

Wuhan between February 4 and February 7, 2020. Participants
were all college students from Wuhan. People who completed the
questionnaire received an antiepidemic kit by express mail. All
respondents understood study objectives and consented to partic-
ipate in this study. Respondents were assured that privacy and
confidentiality would be maintained.
A total of 384 valid samples were collected. Fifteen invalid
samples were excluded because of extreme values. In total, 96% of
the data were valid. Among valid samples, 178 (46.4%) were male
college students and 206 (53.6%) were female college students;
124 (32.3%) were an only-child and 260 (67.7%) were not an
only-child. There were 333 (86.7%) who lived with family during
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Figure 1. Hypothetical model. the quarantine period and 51 (13.3%) lived with others or alone.
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Additionally, 343 (89.3%) students had received psychological

Method training, including psychological lectures and activities in the past,
and 41 (10.7%) had never received this training (see Table 1).
Materials
There were four variables and scales in this study, and responses Analytical Method
were scored using a 5-point Likert scale ranging from 1 (strongly SPSS and AMOS were used for data analyses. Structural equa-
disagree) to 5 (strongly agree), which can be described as follows. tion modeling (SEM) was used to test the data from Wuhan
2019-nCoV victimization experience. The 2019-nCoV vic- students and the hypothetical model. Furthermore, the measure-
timization experience was defined as negative thoughts associated ment and structural models were verified (Bollen, 1989; Byrne,
with the coronavirus event and psychological trauma associated 2010; Kline, 2010; Schumacker & Lomax, 2004). A reasonable
with the disaster breakout process. There are two parts of the measurement model was tested using the confirmatory factor anal-
2019-nCoV victimization experience: catastrophic cognition and ysis (CFA), and model parameters and fit indices obtained from
trauma symptoms. Catastrophic cognition was described as focus- the maximum likelihood estimation were taken as statistical indi-
ing on the negative aspects of the disaster event (Jermann et al., cators to confirm the collocation degree between Wuhan students’
2006). Trauma symptoms were described as those resulting from data and the measurement mode. Statistical indicators included
individuals experiencing, witnessing, or facing various stressful factor loadings per factor and measurement errors. The following
events related to the occurrence of coronavirus. Negative psycho- eight fit indices were determined: ␹2, ␹2/df, root mean square error
logical symptoms can develop, such as a feeling of tension, fear of of approximation (RMSEA), comparative fit index (CFI), normed
infection, insomnia, and moodiness (Chen & Lai, 2012). The scale fit index (NFI), goodness of fit index (GFI), Tucker-Lewis index
of the coronavirus victimization experience contains eight items: (TLI), and parsimonious normed fit index (PNFI; Bollen, 1989;
four related to the level of negative cognition regarding the event Schumacker & Lomax, 2004). Moreover, the reliability and valid-
(Jermann et al., 2006) and four related to symptoms (Chen & Lai, ity were confirmed using Cronbach’s ␣ coefficient, composite
2012). reliability (CR), and average variance extracted (AVE). Further-
Positive thinking. Positive thinking was described as using more, the main effect and structural model were reported, includ-
positive and optimistic thoughts instead of negative and pessimis- ing model fit indexes, path coefficients, and explained variances;
tic thinking when facing stressful events (Jermann et al., 2006). the mediator roles were verified using a bootstrap method.
Positive thinking was measured by the extent of positive thinking
instead of the extent of negative thinking. It contained four items
Reliability and Validity
related to the positive thinking ability (Jermann et al., 2006).
Resilience. Resilience is a positive factor in adapting to stress The measurement model of factor loadings revealed that the per
and coping with trauma (Campbell-Sills & Stein, 2007). The scale factor loading value exceeded .50 as illustrated in Figure 2. How-
of resilience was used to measure self-cognition when faced with ever, 26 items were valid, as listed in Table 2.
stressful events. The scale contains 10 items relating to the level of
coping with stress and trauma (Campbell-Sills & Stein, 2007). Table 1
Mental health. Mental health is defined as a self-evaluation Demographic Distribution of the Samples
of psychological state and cognitive function, including life mean-
ing, thinking and studying abilities, and self-appearance (Zhang, Characteristics Groups N %
Cheng, Chin, & Lee, 2013). The scale of mental health was used
Sex Male 178 46.4
to measure the degree of mental health. The scale contained four Female 206 53.6
items relating to the mental cognition level (Zhang et al., 2013). Only-child Yes 124 32.3
No 260 67.7
Participants Living with family during the Yes 333 86.7
quarantine period No 51 13.3
To stem the spread of the 2019-nCoV, the Chinese government Received psychological training Yes 343 89.3
No 41 10.7
announced Wuhan city’s closure on January 23, 2020. An online
 EFFECTS OF 2019-NCOV ON COLLEGE STUDENTS IN WUHAN S9

.85 .72
Q1 e1
.87 .76
Catastrophic Q2 e2
.72
.52
Cognition .92 Q3 e3
.84
Q4 e4
.78
.77 .60
Q5 e5
Trauma .84 .70
.70 Q6 e6
-.31 Symptoms .49
.80
Q7 e7
.64
-.28 Q8 e8
.86 .75
Q9 e9
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.87 .76
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-.29 Positive Q10 e10

.85
Thinking .77
.72
Q11 e11
-.37 .59
Q12 e12
.57
.75 Q13 e13
-.40 .58
.63 .76 Q14 e14
.48
.69 Q15 e15
-.45
.81 .66
Q16 e16
.78 .61
Q17 e17
.60 Resilience .87 .75
.89 Q18 e18
.87 .79
.84 Q19 e19
.75
.87 Q20 e20
.71
.74 Q21 e21
.75
Q22 e22
.74 .54
Q23 e23
.75 .56
Mental Q24 e24
.88
.77
Health .90 Q25 e25
.82
Q26 e26

Figure 2. Measurement model.

The research data had to satisfy normal distribution. The skew-
ness absolute values for the 26 items were between .35 and 1.93,
and the kurtosis absolute values for the 26 items were between .07
and 3.30. The results satisfied the standards of the absolute value
for skewness ⬍2 and kurtosis ⬍7 (Curran, West, & Finch, 1996).
Cronbach’s ␣ values, the reliability coefficient, were used to
evaluate the consistency of variables. The values were .91, .90, .95,
and .89 in the 2019-nCoV victimization experience scale, positive
thinking scale, resilience scale, and mental health scale, respec-
tively. These findings indicated a high consistency in measuring
results.
It was necessary to verify the convergent validity and discrim-
inate validity of the measurement model. First, the CFA of the
measurement model indicated that there were no negative error
variances and were all significant. All factor loadings were ⱖ.50
(see Figure 2), and their t-values were all significant (Bagozzi &
Yi, 2012; Fornell & Larcker, 1981). Consequently, the measure-
ment model had no offending estimate phenomenon and satisfied
the testing standard for the overall fit.
Second, the model fit indices revealed a reasonable fit with data
from Wuhan students: ␹2 ⫽ 1067.91 (p ⬍ .001), ␹2/df ⫽ 3.70,
RMSEA ⫽ .08, CFI ⫽ .91, NFI ⫽ .88, GFI ⫽ .82, TLI ⫽ .90, and
PNFI ⫽ .78 (Bollen, 1989; Schumacker & Lomax, 2004). Third,
the CR and AVE of the measurement model were .60 and .40,
respectively. The CR and AVE of all variables ranged from .86 to
.95 and .61 to .71, respectively, as displayed in Table 3. These
findings indicated that the measurement model was an acceptable
model with convergent validity (Slater, Hult, & Olson, 2007).
The correlations between two variables ranged from ⫺.26 to .72
and were all significant (p ⬍ .001). The squared correlations from
two variables were all less than the corresponding AVE (see Table
3). These results further revealed that there was discriminant
 S10 YANG, TU, AND DAI

Table 2
The Mean, SD, Standardized Regression Coefficients (SRC), and t Value in Catastrophic Cognition (CC), Trauma Symptoms (TS),
Positive Thinking (PT), Resilience (R), and Mental Health (MH)

Variable No. Questionnaire items M SD SRC t value

CC Q1 I do not think anyone has had a worse 1.68 1.06 .85 11.03ⴱⴱⴱ
experience than me
Q2 I think that what happened to me was the worst 1.54 0.96 .87 10.29ⴱⴱⴱ
Q3 I frequently think about how bad things have 1.89 1.26 .72 12.70ⴱⴱⴱ
become
Q4 I frequently think about how terrible what had 1.55 0.99 .92 8.11ⴱⴱⴱ
happened to me is
TS Q5 My body often feels tense 1.99 1.17 .77 11.19ⴱⴱⴱ
Q6 I am often worried about becoming infected 1.97 1.19 .84 9.75ⴱⴱⴱ
Q7 I frequently cannot sleep 1.72 1.10 .70 12.16ⴱⴱⴱ
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Q8 My mood is always fluctuating 1.84 1.16 .80 10.66ⴱⴱⴱ

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PT Q9 I think of more pleasant subjects than these 4.17 1.09 .86 9.93ⴱⴱⴱ
unpleasant experiences
Q10 I think about happy things, rather than the 4.01 1.17 .87 9.61ⴱⴱⴱ
things that have happened
Q11 It is useless to be constantly sad and in pain, so 4.34 0.99 .85 10.42ⴱⴱⴱ
I choose to look at this event more positively
Q12 I think of pleasant subjects that have nothing to 3.97 1.18 .77 11.95ⴱⴱⴱ
do with this event
R Q13 I am able to adapt to change 4.16 1.03 .75 13.06ⴱⴱⴱ
Q14 I can deal with whatever comes 3.63 1.13 .76 13.04ⴱⴱⴱ
Q15 I try to see the humorous side of problems 3.68 1.21 .69 13.31ⴱⴱⴱ
Q16 Coping with stress can strengthen me 3.96 1.08 .81 12.70ⴱⴱⴱ
Q17 I tend to bounce back after illness or hardship 3.85 1.18 .78 12.91ⴱⴱⴱ
Q18 I can achieve goals despite obstacles 3.92 1.06 .87 12.08ⴱⴱⴱ
Q19 I can stay focused under pressure 3.74 1.14 .89 11.60ⴱⴱⴱ
Q20 I am not easily discouraged by failure 3.80 1.12 .87 12.06ⴱⴱⴱ
Q21 I think of myself as a strong person 4.05 1.07 .84 12.41ⴱⴱⴱ
Q22 I can cope with unpleasant feelings 3.91 1.09 .87 12.08ⴱⴱⴱ
MH Q23 I feel that my life is meaningful 4.33 0.99 .74 12.40ⴱⴱⴱ
Q24 I can concentrate (thinking, studying, and 3.90 1.11 .75 12.33ⴱⴱⴱ
remembering) on what I want to do
Q25 I can accept my appearance 4.13 1.02 .88 9.54ⴱⴱⴱ
Q26 I am satisfied with myself 3.96 1.08 .90 8.26ⴱⴱⴱ
ⴱⴱⴱ
p ⬍ .001.

validity between the variables. The results of factor loadings,
reliability coefficient, model fit, and construct validity indicated a
reasonable quality in the measurement model.
Finally, this study in the self-report measuring process used
a psychological isolation method to make variables mutually
independent to avoid common method variance (CMV) as much
as possible (Peng, Kao, & Lin, 2006). The questionnaire mea-
sured four potential variables at the same time point. A guide-
line was provided before the test questions of each variable so
that respondents understood the purpose of questions for each
variable. For instance, the guideline for the trauma symptom
dimension was “the following questions are to understand your
psychological condition during the outbreak of 2019-nCoV.”
Moreover, the single-factor model constructed using 26 items
demonstrated an unsuitable model fit: ␹2 ⫽ 3732.24 (p ⬍ .001),
␹2/df ⫽ 12.48, RMSEA ⫽ .17, CFI ⫽ .58, NFI ⫽ .57, GFI ⫽
.47, TLI ⫽ .55, and PNFI ⫽ .52. These findings confirmed
that this study had no considerable CMV (Verhagen & van

Table 3
CR and AVE From Measurement Model and Correlation Matrix of Variables

Catastrophic Trauma Positive

Variable cognition symptoms thinking Resilience Mental health

Catastrophic cognition .91 (.71)

Trauma symptoms .72 (.52) .86 (.61)
Positive thinking ⫺.30 (.09) ⫺.26 (.07) .90 (.70)
Resilience ⫺.28 (.08) ⫺.34 (.12) .60 (.36) .95 (.67)
Mental health ⫺.39 (.15) ⫺.43 (.18) .56 (.31) .72 (.52) .89 (.67)
Note. CR ⫽ composite reliability; AVE ⫽ average variance extracted. The numbers on diagonal are CR(AVE). The numbers on lower diagonal are
correlation coefficients of two variables and square numbers of correlation coefficients.
 EFFECTS OF 2019-NCOV ON COLLEGE STUDENTS IN WUHAN
Dolen, 2011). Therefore, the structural model was further
analyzed.
Results
Main Effect
Using SEM to test the main effect path, the standardized regres-
sion coefficients of 12 items of the main effect were found to be
between .71 and .92. The main effect path demonstrated that this
model was a suitable fit for the sample data: ␹2 ⫽ 248.62 (p ⬍
.001), ␹2/df ⫽ 4.88, RMSEA ⫽ .10, GFI ⫽ .90, CFI ⫽ .94, NFI ⫽
.92, TLI ⫽ .92, and PNFI ⫽ .71 (Bollen, 1989; Schumacker &
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Lomax, 2004). The path coefficient is displayed in Figure 3.
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Hypothesis 1 was confirmed because 2019-nCoV victimization
experience explained 23% of the variance in mental health
(␥ ⫽ ⫺.48, p ⬍ .001).
Structural Model
Hypotheses 2 and 3 involved two mediating effects that consti-
tuted a structural model, as displayed in Figure 4. The standardized
regression coefficients of the 26 items in the structural model were
between .69 and .92. The fit of the structural model was reason-
able: ␹2 ⫽ 1197.33 (p ⬍ .001), ␹2/df ⫽ 4.10, RMSEA ⫽ .09,
GFI ⫽ .81, CFI ⫽ .89, NFI ⫽ .86, TLI ⫽ .88, and PNFI ⫽ .77
(Bollen, 1989; Schumacker & Lomax, 2004). According to the
structural model, the total indirect effect between 2019-nCoV
victimization experience and mental health was ⫺.29; the boot-
strap standard error was .07; the confidence interval of the bias-
corrected percentile method was ⫺.45 to ⫺.17 (p ⫽ .001 two-
tailed); and the confidence interval of the percentile method
was ⫺.44 to ⫺.17 (p ⫽ .002 two-tailed).
The scarcity of 0 between the confidence intervals of the total
indirect effect indicated that a mediator effect existed in the
structural model. Moreover, the total direct effect between 2019-
nCoV victimization experience and mental health was ⫺.21; the
bootstrap standard error was .10; the confidence interval of bias-
corrected percentile method was ⫺.36 to ⫺.06 (p ⫽ .003 two-
tailed); and the confidence interval of the percentile method
was ⫺.37 to ⫺.07 (p ⫽ .002 two-tailed). The scarcity of 0 between
confidence intervals in the total direct effect indicated that the
effect of the structural model was partially mediated.
PRODCLIN2 was then used to verify whether the mediating
roles of positive thinking and resilience were present in the struc-
tural model (Mackinnon, Fritz, Williams, & Lockwood, 2007).
Mackinnon PRODCLIN2 95% confidence interval (CI) was be-
tween ⫺.09 and ⫺.04, which was calculated using parameters of
2019-nCoV -.48*
Mental
Victimization
Health
Experience
Figure 3. Main effect of 2019 novel coronavirus (2019-nCoV) victim-
ization experience and mental health.
S11
-.38* Positive
.19*
Thinking
2019-nCoV
-.23* Mental
Victimization
Health
Experience
Resilience
.57*
-.42*
Figure 4. Structural model.
2019-nCoV victimization experience, positive thinking, and men-
tal health; it indicated that positive thinking was a mediator role in
the model. Mackinnon PRODCLIN2 95% CI was ⫺.32 to ⫺.13,
which was calculated using the parameters of 2019-nCoV victim-
ization experience, resilience, and mental health. The findings
indicated that resilience was a mediator in the model. Thus, pos-
itive thinking and resilience were mediators and played partial
intermediary roles in the structural model. Hypotheses 2 and 3
were supported.
The path coefficients of the structural model are displayed in
Figure 4. The 2019-nCoV victimization experience explained 15%
of the variance in positive thinking (␥ ⫽ ⫺.38, p ⬍ .001); the
2019-nCoV victimization experience explained 18% of the vari-
ance in resilience (␥ ⫽ ⫺.42, p ⬍ .001), positive thinking (␥ ⫽
.19, p ⬍ .001), and resilience (␥ ⫽ .57, p ⬍ .001); 2019-nCoV
victimization experience (␥ ⫽ ⫺.23, p ⬍ .001) collectively ex-
plained 59% of the variance in mental health.
Based on the main effect of the 2019-nCoV victimization ex-
perience on mental health and the structural model, the path
coefficient of the effect of the 2019-nCoV victimization experi-
ence on mental health was reduced from ⫺.48 to ⫺.23 when the
two mediators were added. These findings indicate that the strong
negative effect of the 2019-nCoV victimization experience on
mental health was considerably weakened by positive thinking and
resilience.
Discussion
The findings verified Hypothesis 1, illustrated in Figure 3,
confirming that 2019-nCoV victimization experiences are negative
stimuli that have a significant negative effect on mental health.
This result is in accordance with the literature (Artime et al., 2019;
Becker-Blease et al., 2010; Bonanno et al., 2008; Park et al., 2018;
Steel et al., 2002). In college students, who had mainly been
college students, experiencing, witnessing, or facing various stress
events related to the occurrence of 2019-nCoV resulted in negative
psychological symptoms, such as a sense of tension, fear of infec-
tion, insomnia, and low mood. Despite the spread of 2019-nCoV
being already controlled by blocking cities and limiting transpor-
tation (Burki, 2020), 2019-nCoV resulted in trauma and numerous
negative emotions (Kang et al., 2020; Xiang et al., 2020).
The study also verified Hypotheses 2 and 3 by using the struc-
tural model. The 2019-nCoV victimization experience had a sig-
nificant negative effect on positive thinking (Cadamuro et al.,
 S12 YANG, TU, AND DAI
2015). Moreover, positive thinking had a significant positive effect
on mental health (Aspinwall & Tedeschi, 2010; Bekhet, 2013;
Naseem & Khalid, 2010; Norem & Chang, 2002; Tugade &
Fredrickson, 2004). Therefore, experiencing the 2019-nCoV vic-
timization experience will hinder Wuhan college students’ positive
thinking, despite positive thinking reducing the negative emotions
of college students through emotional adjustment and cognitive
experience (Birrer, Röthlin, & Morgan, 2012).
The 2019-nCoV victimization experience had a significant neg-
ative effect on resilience (Arnason, 2009; Peng et al., 2012). Yet,
resilience had a significant positive effect on mental health (Chow
& Choi, 2019; Dray et al., 2017, 2015; Goldmann & Galea, 2014;
Hildebrand et al., 2019; Jakovljevic, 2018; Siriwardhana et al.,
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
2014). Therefore, the structural model results revealed that posi-
This document is copyrighted by the American Psychological Association or one of its allied publishers.
tive thinking and resilience were partial mediators in the relation-
ship of Hypothesis 1. The positive functions of positive thinking
and resilience were identified in the structural model, which indi-
cates that the 2019-nCoV event was not sufficient to impair the
functions of positive thinking and resilience.
The study results, and previous theories, allowed the function of
mediating mechanisms on mental health to be reasonably ex-
plained. First, positive thinking and resilience were added to the
relationship between 2019-nCoV victimization experience and
mental health. The positive effect that reduced the negative influ-
ence of 2019-nCoV victimization experience on the mental health
of Wuhan’s college students was evident. This finding signifies
that mental health among Wuhan’s college students can be im-
proved through positive thinking and resilience during the 2019-
nCoV breakout. Therefore, enhancing positive thinking and resil-
ience may be a means to protect the psychological health of
Wuhan’s college students.
Evidence supporting cognitive appraisal theory (Folkman &
Lazarus, 1984) suggested that using positive thinking as an ap-
proach to evaluate the stimulus can weaken the negative influence
of 2019-nCoV victimization experiences on mental health. The
mechanism is driven by ignoring or evaluating negative stimuli to
lower the risk. Furthermore, both during and after 2019-nCoV,
strong resilience can be a deterrent that weakens the relationship
between 2019-nCoV victimization experience and negative mental
health (Jakovljevic, 2018; Siriwardhana et al., 2014). Resilience is
the ability to cope with negative effects during disaster periods and
postdisaster (Goldmann & Galea, 2014; Thompson et al., 2018).
Resilience allows the prevention of the negative effects of harmful
stimuli, and it can restore its protective function in disasters and
grow as a result of negative experiences. However, resilience’s
adaptive function has a limit. An individual’s resilience could not
withstand high-intensity and continuous negative stimulations (Ar-
nason, 2009; Masten & Reed, 2002). Therefore, positive thinking
could compensate for the limitations of resilience function.
The MOE of China (2009) reported that Wuhan universities
attach considerable importance to the psychological health educa-
tion of college students and have relevant courses, such as fresh-
man training and public elective courses. Related topics include
physical health, positive relationships, and psychological capital
(such as resilience, optimism and growth mentality, positive think-
ing and meditation, and gratitude). Demographic findings indi-
cated that 89.3% of college students had received psychological
training. This indicates that psychological knowledge and training
were popularized among Wuhan’s college students, which may
have provided early preparation to cope with this negative event.
Conclusion
The findings of this study revealed that positive thinking and
resilience can reduce the negative effect of 2019-nCoV on mental
health among Wuhan’s college students. Because positive thinking
and resilience still work in the model, the 2019-nCoV event may
not be sufficient to affect their function.
Research Suggestions
There are two suggestions provided in this study. First, mental
health problems among Wuhan’s college students should be pre-
vented by psychological health workers because the 2019-nCoV
victimization experience has a strong negative effect on their
mental health.
Second, interventions by psychological health workers to alle-
viate Wuhan college students’ mental health problems during the
2019-nCoV process or postdisaster are crucial. Positive thinking
and resilience training have been used for improving mental health
and inhibiting the development of PTSD during the disaster and
postdisasters (Jakovljevic, 2018; Siriwardhana et al., 2014; Vern-
berg et al., 2008). Study results have suggested that related work-
ers must enhance positive thinking and resilience among Wuhan’s
college students as soon as possible. These two strong mediators
will vastly resist the negative influences of 2019-nCoV victimiza-
tion experience on mental health in Wuhan’s college students until
this disaster subsides in Wuhan.
Limitations and Future Directions
This study only investigated the largest epidemic region in the
Hubei province of China. Unfortunately, the outbreak has spread
globally. Therefore, studies should be conducted in other areas or
countries.
This study used an online questionnaire to collect samples
because of the risk of infection. However, postdisaster interven-
tions may be needed to prevent PTSD in Hubei. Follow-up re-
search could survey face to face.
This study only used data from Wuhan’s college students to
construct a model of interventions in mental health, and the model
may not be suitable for extrapolation to other groups or other types
of disaster events. Therefore, this model should be verified in other
situations before applying it to other affected people.
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Received March 21, 2020
Revision received May 6, 2020
Accepted May 13, 2020 䡲